<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    <input type="hidden" name="row[scenario]" value="add" />
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('选择礼卡')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_select('row[card_id]', $cardList, $Request.get.card_id, ['class'=>'form-control selectpicker'])}
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('卡号')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-number" class="form-control" type="text" name="row[number]" title="" value="" data-rule="required">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('卡密')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-password" class="form-control" type="text" name="row[password]" title="" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('手机号')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-phone" class="form-control" type="text" name="row[phone]" title="" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('备注')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-note" class="form-control" type="text" name="row[note]" title="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_radios('row[status]', $statusListOther, null)}
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button class="btn btn-success btn-embossed disabled" type="submit">{:__('OK')}</button>
            <button class="btn btn-default btn-embossed" type="reset">{:__('Reset')}</button>
        </div>
    </div>
</form>
